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21st Century Cures Act Compliance – Part Three: LTPAC’s Unique Challenges & How We’re Helping

Having just surpassed the one year anniversary of the COVID-19 pandemic – a time when interoperability and data exchange have never been more important – we are reminded that The 21st Century Cures Act (“Cures Act”) compliance day (April 5th) is just around the corner. We’ve already provided a backdrop of what these regulations look like and what their implcations will be as providers work to ensure they’ll be compliant. But it’s also important to consider that when it comes to the Cures Act, not all providers are alike.

Why LTPAC is different

Long-term post-acute care (LTPAC) providers face unique challenges in implementing and complying with the requirements of the Cures Act, including the “Final Rule”, since this sector is fundamentally different from other segments of healthcare, such as acute care and primary care. For example, LTPAC is longitudinal, not episodic, meaning that aspects of care occur in an ongoing manner versus a single visit or one-time treatment. Many seniors face ongoing health issues, such as chronic diseases, that are never cured but rather monitored and managed on an ongoing basis. In fact, the typical long-term care resident has more than 10 co-morbidities, adding to the complexity of care delivery. Meanwhile, an acute patient may just need an x-ray before being discharged.

For LTPAC, electronic health record (EHR) documentation is more complex and difficult to summarize, communicate, and share. Moreover, there is high variation in acuity and the level of clinical services provided across the sector. Skilled nursing facilities provide high levels of clinical care, and senior living provides less direct medical care to residents. Even within LTPAC, one size does not fit all.

Additionally, LTPAC providers traditionally have less technological capacity, expertise, and investment compared to other sectors within healthcare. Historically, LTPAC has not been the focus of efforts to shift to value-based care, which often included government funding for health IT investment, leaving many providers playing ‘catch-up’ to ensure data integration and transparency across the continuum. And even if they have, their IT budgets are often limited, hindering their investment in IT infrastructure and development.

These unique challenges made it difficult for LTPAC providers to prepare for the compliance deadline, especially when battling the added complications of the pandemic – which is why, at PointClickCare, we advocated in Washington D.C. for the delay until April.

Advocating for the senior care industry

Throughout this transition, PointClickCare has worked with industry leaders and directly with the ONC to advocate not only for our customers but for the entire LTPAC industry. Back in September 2020, we wrote a letter to the ONC outlining the unique challenges the senior care industry faces. These endeavors, along with our advocacy efforts through partners such as The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and The National Association for Senior Living (NASL), helped lead the ONC toward delaying compliance from November 2020 to April 2021.

Since then, we’ve worked even harder with the NASL and other organizations to continue shaping the policies, regulations, and requirements around interoperability in health care. We support the objectives of the Cures Act, and our focus has been on advocating for the goals and objectives of interoperability while ensuring that any new requirements emphasize the use of industry standards and existing solutions. We also want to help regulators and policymakers work collaboratively between the state and federal levels so that providers don’t have to work to meet more than fifty sets of rules across all the states and territories. Ultimately, we hope to avoid onerous, inefficient, and unintended consequences on the quest for interoperability. Instead, we strive to achieve focused and effective regulation that not only reflects the reality of the unique LTPAC sector but also allows for all stakeholders within healthcare to truly benefit from improved data sharing.

We’re here for you

In addition to our ongoing advocacy for the LTPAC sector, we’re continuing to provide resources and support to customers as we approach compliance day. If you still have questions, check out the following resources for added guidance:

March 18, 2021